Inter Press Service - September 8, 2005
Marina Penderis

AIDS has caused life expectancy to drop to 30 years in many parts of sub-Saharan Africa - less than half the life expectancy of privileged societies, said Lincoln Chen, director of the Global Equity Centre at the Harvard Kennedy School of Government in the United States.

"We have had more deaths due to AIDS than all the combat casualties of the 20th century," Chen said at a meeting on 'health as a key for security and economic development'.

Health issues can also have an economic impact on wealthy countries. Up to a third of personal bankruptcies in the United States are due to the high cost of sickness. Chen identifies unexpected illnesses as a major cause of economic impoverishment.

"SARS killed only a few people, but paralysed international travel and trade, devastating the Asian and global economies at a cost estimated at more than 60 billion dollars," he said. "Without health protection, the devastating economic impact of illness is observed in all societies."

The United Nations' Millennium Development Goals relating to the reduction of mortality among mothers and children under five, as well as the halting of the spread of HIV/AIDS, malaria and tuberculosis are far from being reached.

Some five million new HIV infections develop each year. There are 300-500 million malaria cases a year, and malaria kills up to three million children a year.

Studies by some economists suggest that the gross domestic product (GDP) of sub-Saharan Africa in 2000 would have been 25 percent higher if malaria had been eliminated in 1965. The disease continues to undercut sub-Saharan Africa's gross domestic product (GDP) per capita growth rates by some 1.3 percentage points a year, the studies say.

"There is no doubt that malaria depresses the economy, especially in Africa," said Chen.

George Alleyne, director emeritus of the Pan-American Health Organisation, and chair of the Caribbean Commission's panel on macroeconomics and health, said international cooperation was necessary to address health crises.

"There has to be mutuality of interest. We must not discount cooperation based on charity completely, but it is not the basis for a long-term solution," he said.

All countries, even the poorest, should contribute resources to address health crises, said Alleyne. "I think the concept of a donor is pejorative in the context of a global initiative."

David Hamburg, president emeritus at the Carnegie Corporation in the United States, said development and health are crucial to preventing war and genocide.

"Well-being is about health, but it is also about equal opportunities. Young men without opportunities are susceptible to enticement by demagogues," said Hamburg. "Education is fundamental. This must include women, not only as a matter of equality, but as a matter of economic stimulus."

Both Hamburg and Neil de Crescenzo, vice-president for global healthcare at the IBM Corporation highlighted the need for early warning systems.

"If you ask most health ministers, 'can I have a reasonably up to date, accurate, timely report on the health status of your citizens?', they'll throw their hands up in despair," said de Crescenzo.

The health sector faces the challenge of finding cost-effective ways to collect data for early warning of potential crises. De Crescenzo gave an example of a low-cost disease prevention programme in India using mobile phone technology to gather data.

Such a measurement tool increases the likelihood that problems will be addressed, he said. "There is an old expression in business: what gets measured, gets done."

Ala'adin Alwan from the World Health Organisation in Amman said lack of political commitment, particularly to finance and planning is another hurdle before those developing ways to address health crises.

Florence Epodoi from the World Organisation of Scouts and Guides said practical problems such as poverty or distance between communities and accessible healthcare create further problems.

"Inaccessible services are a problem if someone is poor and cannot afford transport," said Epodoi.

Sergio Spinaci, executive secretary of the World Health Organisation, said health crises are often not highly visible.

"Health is about the prevention of deaths, but those are silent deaths. Something like the tsunami is more visible," he said.

The last century witnessed spectacular health advances, but progress has been interrupted in the new century, said Chen. He believes the HIV/AIDS epidemic is likely to influence the course of history just as the Black Death did in 14th century Europe.

"More and more people recognise that we live in a world with sufficient knowledge and resources to avoid much human suffering, yet literally millions of people still suffer and die from preventable causes," he said. "More than ten million children under the age of five die form causes that are entirely preventable or treatable with effective, affordable measures such as immunisaton and antibiotics."

Chen suggested funding a global health system through tax on airplane tickets. "Airlines have three things that can hurt their industry -- terrorism, accidents and epidemics. So, it makes sense for them to charge a fee that can be used to control epidemics."

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